Surgical staple buttress with magnetic elements

ABSTRACT

An apparatus includes an end effector including an anvil and lower jaw. The anvil is pivotable toward the lower jaw to capture tissue. The apparatus further includes a stapling and severing assembly configured to sever and staple tissue clamped between the anvil and the lower jaw. A staple cartridge is coupled with the lower jaw. The staple cartridge includes a deck facing the anvil, a plurality of staples positioned in a plurality of staple openings formed through the deck, and a magnetic feature configured to be coupled to tissue in response to activation of the stapling and severing mechanism. The magnetic feature is configured to be coupled to tissue in response to actuation of the staple cartridge, wherein the magnetic feature is configured to retain at least one outer portion of stapled tissue in an inwardly folded position relative to an inner portion of stapled tissue.

BACKGROUND

In some surgical procedures (e.g., colorectal, bariatric, thoracic,etc.), portions of a patient's digestive tract (e.g., thegastrointestinal tract and/or esophagus, etc.) may be cut and removed toeliminate undesirable tissue or for other reasons. Once the tissue isremoved, the remaining portions of the digestive tract may be coupledtogether in an end-to-end anastomosis. The end-to-end anastomosis mayprovide a substantially unobstructed flow path from one portion of thedigestive tract to the other portion of the digestive tract, withoutalso providing any kind of leaking at the site of the anastomosis.

One example of an instrument that may be used to provide an end-to-endanastomosis is a circular stapler. Some such staplers are operable toclamp down on layers of tissue, cut through the clamped layers oftissue, and drive staples through the clamped layers of tissue tosubstantially seal the layers of tissue together near the severed endsof the tissue layers, thereby joining the two severed ends of theanatomical lumen together. The circular stapler may be configured tosever the tissue and seal the tissue substantially simultaneously. Forinstance, the circular stapler may sever excess tissue that is interiorto an annular array of staples at an anastomosis, to provide asubstantially smooth transition between the anatomical lumen sectionsthat are joined at the anastomosis. Circular staplers may be used inopen procedures or in endoscopic procedures. In some instances, aportion of the circular stapler is inserted through a patient'snaturally occurring orifice.

Examples of circular staplers are described in U.S. Pat. No. 5,205,459,entitled “Surgical Anastomosis Stapling Instrument,” issued Apr. 27,1993; U.S. Pat. No. 5,271,544, entitled “Surgical Anastomosis StaplingInstrument,” issued Dec. 21, 1993; U.S. Pat. No. 5,275,322, entitled“Surgical Anastomosis Stapling Instrument,” issued Jan. 4, 1994; U.S.Pat. No. 5,285,945, entitled “Surgical Anastomosis Stapling Instrument,”issued Feb. 15, 1994; U.S. Pat. No. 5,292,053, entitled “SurgicalAnastomosis Stapling Instrument,” issued Mar. 8, 1994; U.S. Pat. No.5,333,773, entitled “Surgical Anastomosis Stapling Instrument,” issuedAug. 2, 1994; U.S. Pat. No. 5,350,104, entitled “Surgical AnastomosisStapling Instrument,” issued Sep. 27, 1994; and U.S. Pat. No. 5,533,661,entitled “Surgical Anastomosis Stapling Instrument,” issued Jul. 9,1996; and U.S. Pat. No. 8,910,847, entitled “Low Cost Anvil Assembly fora Circular Stapler,” issued Dec. 16, 2014. The disclosure of each of theabove-cited U.S. patents is incorporated by reference herein.

Some circular staplers may include a motorized actuation mechanism.Examples of circular staplers with motorized actuation mechanisms aredescribed in U.S. Pub. No. 2015/0083772, entitled “Surgical Stapler withRotary Cam Drive and Return,” published Mar. 26, 2015; U.S. Pub. No.2015/0083773, entitled “Surgical Stapling Instrument with Drive AssemblyHaving Toggle Features,” published Mar. 26, 2015, now U.S. Pat. No.9,936,949, issued Apr. 10, 2018; U.S. Pub. No. 2015/0083774, entitled“Control Features for Motorized Surgical Stapling Instrument,” publishedMar. 26, 2015, now U.S. Pat. No. 9,907,552, issued Mar. 6, 2018; andU.S. Pub. No. 2015/0083775, entitled “Surgical Stapler with Rotary CamDrive,” published Mar. 26, 2015, now U.S. Pat. No. 9,713,469, issuedJul. 25, 2017. The disclosure of each of the above-cited U.S. patentPublications is incorporated by reference herein.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a perspective view of an exemplary circular stapler;

FIG. 2 depicts a perspective view of the circular stapler of FIG. 1,with a battery pack removed from a handle assembly and an anvil removedfrom a stapling head assembly;

FIG. 3 depicts a perspective view of the anvil of the circular staplerof FIG. 1;

FIG. 4 depicts a perspective view of the stapling head assembly of thecircular stapler of FIG. 1;

FIG. 5 depicts an exploded perspective view of the stapling headassembly of FIG. 4;

FIG. 6 depicts an exploded perspective view of the circular stapler ofFIG. 1, with portions of the shaft assembly shown separately from eachother;

FIG. 7 depicts a schematic view of a lower portion of a patient'sgastrointestinal tract, with an endocutter stapler being utilized tostaple and sever the gastrointestinal tract at a first location and theendocutter stapler being utilized to staple and sever thegastrointestinal tract at a second location, thereby dividing thegastrointestinal tract into an upper portion, a transected portion, anda lower portion during a surgical procedure;

FIG. 8 depicts a schematic view of the gastrointestinal tract of FIG. 7during another step of the surgical procedure of FIG. 7, showing theanvil of FIG. 3 positioned in the upper portion of the gastrointestinaltract and the stapling head assembly of FIG. 4 positioned in the lowerportion of the gastrointestinal tract, with the anvil and the staplinghead assembly and adjacent regions of the gastrointestinal tract shownin cross-section;

FIG. 9 depicts a schematic view of the gastrointestinal tract of FIG. 7during another step of the surgical procedure of FIG. 7, showing theupper portion and the lower portion of the patient's gastrointestinaltract being compressed between the anvil and the stapling head assemblyof the circular stapler of FIG. 1, with the anvil and the stapling headassembly and adjacent regions of the gastrointestinal tract shown incross-section;

FIG. 10 depicts a schematic view of the gastrointestinal tract of FIG. 7upon completion of the surgical procedure of FIG. 7, with the upper andlower portions of the patient's gastrointestinal tract joined by staplesdeployed from the circular stapler of FIG. 1, providing an anastomosisbetween the upper and lower portions of the patient's gastrointestinaltract, with the anastomosis and adjacent regions of the gastrointestinaltract shown in cross-section;

FIG. 11 depicts a perspective view of an exemplary alternative staplecartridge suitable for use in the endocutter stapler of FIG. 7 duringperformance of the procedure of FIG. 7, including a buttress withmagnetic elements secured to a deck of the staple cartridge;

FIG. 12 depicts a side elevational view showing a portion of thegastrointestinal tract after having been stapled and severed utilizingthe staple cartridge of FIG. 11, with the buttress in an unfoldedconfiguration;

FIG. 13 depicts a top view of the portion of the gastrointestinal tractof FIG. 12, with the buttress in a folded configuration;

FIG. 14A depicts a schematic view of severed upper and lower portions ofa patient's gastrointestinal tract, with the buttress of FIG. 11 appliedto the severed end of the lower portion of the gastrointestinal tract,showing the anvil of FIG. 3 positioned in the upper portion of thegastrointestinal tract and the stapling head assembly of FIG. 4positioned in the lower portion of the gastrointestinal tract, during asurgical procedure;

FIG. 14B depicts a schematic view of the gastrointestinal tract of FIG.14A during another step of the surgical procedure of FIG. 14A, showingthe upper portion and the lower portion of the patient'sgastrointestinal tract being compressed between the anvil and thestapling head assembly of the circular stapler of FIG. 1, with the anviland the stapling head assembly and adjacent regions of thegastrointestinal tract shown in cross-section;

FIG. 14C depicts a schematic view of the gastrointestinal tract of FIG.14A upon completion of the surgical procedure of FIG. 14A, with theupper and lower portions of the patient's gastrointestinal tract joinedby staples deployed from the circular stapler of FIG. 1, providing ananastomosis between the upper and lower portions of the patient'sgastrointestinal tract, with the anastomosis and adjacent regions of thegastrointestinal tract shown in cross-section;

FIG. 15 depicts a side elevational view showing a portion of thegastrointestinal tract after having been stapled and severed utilizing astaple cartridge including at least some ferromagnetic staples; and

FIG. 16 depicts a schematic view of severed upper and lower portions ofa patient's gastrointestinal tract, with the ferromagnetic staples ofFIG. 15 applied to the severed end of the lower portion of thegastrointestinal tract, showing the anvil of FIG. 3 positioned in theupper portion of the gastrointestinal tract and the stapling headassembly of FIG. 4 positioned in the lower portion of thegastrointestinal tract, during a surgical procedure.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

I. Overview of Exemplary Circular Stapling Surgical Instrument

FIGS. 1-2 depict an exemplary surgical circular stapling instrument (10)that may be used to provide an end-to-end anastomosis between twosections of an anatomical lumen such as a portion of a patient'sdigestive tract. Instrument (10) of this example comprises a handleassembly (100), a shaft assembly (200), a stapling head assembly (300),an anvil (400), and a removable battery pack (120). Each of thesecomponents will be described in greater detail below. It should beunderstood that, in addition to or in lieu of the following, instrument(10) may be further constructed and operable in accordance with at leastsome of the teachings of U.S. Pub. No. 2016/0374670, entitled “AnvilStabilization Features for Surgical Stapler,” published Dec. 29, 2016;U.S. Pat. No. 5,205,459; U.S. Pat. No. 5,271,544; U.S. Pat. No.5,275,322; U.S. Pat. No. 5,285,945; U.S. Pat. No. 5,292,053; U.S. Pat.No. 5,333,773; U.S. Pat. No. 5,350,104; U.S. Pat. No. 5,533,661; and/orU.S. Pat. No. 8,910,847, the disclosures of which are incorporated byreference herein. Still other suitable configurations will be apparentto one of ordinary skill in the art in view of the teachings herein.

A. Exemplary Tissue Engagement Features of Circular Stapling Instrument

As best seen in FIG. 3, anvil (400) of the present example comprises ahead (410) and a shank (420). Head (410) includes a proximal surface(412) that defines a plurality of staple forming pockets (414). Stapleforming pockets (414) are arranged in two concentric annular arrays inthe present example. Staple forming pockets (414) are configured todeform staples as the staples are driven into staple forming pockets(414) (e.g., deforming a generally “U” shaped staple into a “B” shape asis known in the art). Shank (420) defines a bore or lumen (422) andincludes a pair of pivoting latch members (430) positioned in bore(422). Each latch member (430) includes features that allows anvil (400)to be removably secured to a trocar (330) of stapling head assembly(300) as will be described in greater detail below. It should beunderstood, however, that anvil (400) may be removably secured to atrocar (330) using any other suitable components, features, ortechniques.

Stapling head assembly (300) is located at the distal end of shaftassembly (200). As shown in FIGS. 1-2, anvil (400) is configured toremovably couple with shaft assembly (200), adjacent to stapling headassembly (300). As will be described in greater detail below, anvil(400) and stapling head assembly (300) are configured to cooperate tomanipulate tissue in three ways, including clamping the tissue, cuttingthe tissue, and stapling the tissue. As best seen in FIGS. 4-5, staplinghead assembly (300) of the present example comprises a tubular casing(310) housing a slidable staple driver member (350). A cylindraceousinner core member (312) extends distally within tubular casing (310).Tubular casing (310) is fixedly secured to an outer sheath (210) ofshaft assembly (200), such that tubular casing (310) serves as amechanical ground for stapling head assembly (300).

Trocar (330) is positioned coaxially within inner core member (312) oftubular casing (310). Trocar (330) is operable to translate distally andproximally relative to tubular casing (310) in response to rotation of aknob (130) located at the proximal end of handle assembly (100). Trocar(330) comprises a shaft (332) and a head (334). Head (334) includes apointed tip (336) and an inwardly extending proximal surface (338). Head(334) and the distal portion of shaft (332) are configured for insertionin bore (422) of anvil (420). Proximal surface (338) is configured tocomplement features of latch members (430) to provide a snap fit betweenanvil (400) and trocar (330).

Staple driver member (350) is operable to actuate longitudinally withintubular casing (310) in response to activation of motor (160) as will bedescribed in greater detail below. Staple driver member (350) includestwo distally presented concentric annular arrays of staple drivers(352). Staple drivers (352) are arranged to correspond with thearrangement of staple forming pockets (414) described above. Thus, eachstaple driver (352) is configured to drive a corresponding staple into acorresponding staple forming pocket (414) when stapling head assembly(300) is actuated. Staple driver member (350) also defines a bore (354)that is configured to coaxially receive core member (312) of tubularcasing (310).

A cylindraceous knife member (340) is coaxially positioned within stapledriver member (350). Knife member (340) includes a distally presented,sharp circular cutting edge (342). Knife member (340) is sized such thatknife member (340) defines an outer diameter that is smaller than thediameter defined by the inner annular array of staple drivers (352).Knife member (340) also defines an opening that is configured tocoaxially receive core member (312) of tubular casing (310).

A deck member (320) is fixedly secured to tubular casing (310). Deckmember (320) includes a distally presented deck surface (322) definingtwo concentric annular arrays of staple openings (324). Staple openings(324) are arranged to correspond with the arrangement of staple drivers(352) and staple forming pockets (414) described above. Thus, eachstaple opening (324) is configured to provide a path for a correspondingstaple driver (352) to drive a corresponding staple through deck member(320) and into a corresponding staple forming pocket (414) when staplinghead assembly (300) is actuated. It should be understood that thearrangement of staple openings (322) may be modified just like thearrangement of staple forming pockets (414) as described above. Itshould also be understood that various structures and techniques may beused to contain staples within stapling head assembly (300) beforestapling head assembly (300) is actuated. Deck member (320) defines aninner diameter that is just slightly larger than the outer diameterdefined by knife member (340). Deck member (320) is thus configured toallow knife member (340) to translate distally to a point where cuttingedge (342) is distal to deck surface (322).

FIG. 6 shows various components of shaft assembly (200), which extendsdistally from handle assembly (100) and couples components of staplinghead assembly (300) with components of handle assembly (100). Inparticular, and as noted above, shaft assembly (200) includes an outersheath (210) that extends between handle assembly (100) and tubularcasing (310). In the present example, outer sheath (210) is rigid andincludes a preformed curved section that is configured to facilitatepositioning of stapling head assembly (300) within a patient's colon.

Shaft assembly (200) further includes a trocar actuation rod (220) and atrocar actuation band assembly (230). The distal end of trocar actuationband assembly (230) is fixedly secured to the proximal end of trocarshaft (332). The proximal end of trocar actuation band assembly (230) isfixedly secured to the distal end of trocar actuation rod (220), suchthat trocar (330) will translate longitudinally relative to outer sheath(210) in response to translation of trocar actuation band assembly (230)and trocar actuation rod (220) relative to outer sheath (210). Trocaractuation band assembly (230) is configured to flex such that trocaractuation band assembly (230) may follow along the preformed curve inshaft assembly (200) as trocar actuation band assembly (230) istranslated longitudinally relative to outer sheath (210). However,trocar actuation band assembly (230) has sufficient column strength andtensile strength to transfer distal and proximal forces from trocaractuation rod (220) to trocar shaft (332). Trocar actuation rod (220) isrigid. A clip (222) is fixedly secured to trocar actuation rod (220) andis configured to cooperate with complementary features within handleassembly (100) to prevent trocar actuation rod (220) from rotatingwithin handle assembly (100) while still permitting trocar actuation rod(220) to translate longitudinally within handle assembly (100). Trocaractuation rod (220) further includes a coarse helical threading (224)and a fine helical threading (226).

Shaft assembly (200) further includes a stapling head assembly driver(240) that is slidably received within outer sheath (210). The distalend of stapling head assembly driver (240) is fixedly secured to theproximal end of staple driver member (350). The proximal end of staplinghead assembly driver (240) is secured to a drive bracket (250) via a pin(242). It should therefore be understood that staple driver member (350)will translate longitudinally relative to outer sheath (210) in responseto translation of stapling head assembly driver (240) and drive bracket(250) relative to outer sheath (210). Stapling head assembly driver(240) is configured to flex such that stapling head assembly driver(240) may follow along the preformed curve in shaft assembly (200) asstapling head assembly driver (240) is translated longitudinallyrelative to outer sheath (210). However, stapling head assembly driver(240) has sufficient column strength to transfer distal forces fromdrive bracket (250) to staple driver member (350).

B. Exemplary User Input Features of Circular Stapling Instrument

As shown in FIG. 1, handle assembly (100) includes a pistol grip (112)and several components that are operable to actuate anvil (400) andstapling head assembly (300). In particular, handle assembly (100)includes knob (130), a safety trigger (140) a firing trigger (150), amotor (160), and a motor activation module (180). Knob (130) is coupledwith trocar actuation rod (220) via a nut (not shown), such that coarsehelical threading (224) will selectively engage a thread engagementfeature within the interior of the nut; and such that fine helicalthreading (226) will selectively engage a thread engagement featurewithin the interior of knob (130). These complementary structures areconfigured such that trocar actuation rod (220) will first translateproximally at a relatively slow rate, then translate proximally at arelatively fast rate, in response to rotation of knob (130).

It should be understood that when anvil (400) is coupled with trocar(330), rotation of knob (130) will provide corresponding translation ofanvil relative to stapling head assembly (300). It should also beunderstood that knob (130) may be rotated in a first angular direction(e.g., clockwise) to retract anvil (400) toward stapling head assembly(300); and in a second angular direction (e.g., counterclockwise) toadvance anvil (500) away from stapling head assembly (300). Knob (130)may thus be used to adjust the gap distance between opposing surfaces(412, 322) of anvil (400) and stapling head assembly (300) until asuitable gap distance has been achieved.

Firing trigger (150) is operable to activate motor (160) to therebyactuate stapling head assembly (300). Safety trigger (140) is operableto selectively block actuation of firing trigger (150) based on thelongitudinal position of anvil (400) in relation to stapling headassembly (300). Handle assembly (100) also includes components that areoperable to selectively lock out both triggers (140, 150) based on theposition of anvil (400) relative to stapling head assembly (300). Whentriggers (140, 150) are locked out, firing trigger (150) is preventedfrom initiating actuation of stapling head assembly (300). Thus, trigger(150) is only operable to initiate actuation of stapling head assembly(300) when the position of anvil (400) relative to stapling headassembly (300) is within a predefined range.

In the present example, firing trigger (150) of the present exampleincludes an integral actuation paddle, such as the paddle shown anddescribed in U.S. Pub. No. 2016/0374666, entitled “Surgical Stapler withReversible Motor,” published Dec. 26, 2016, the disclosure of which isincorporated by reference herein. The paddle is configured to actuate aswitch of motor activation module (180) (FIG. 1) when firing trigger(150) is pivoted to a fired position. Motor activation module (180) isin communication with battery pack (120) and motor (160), such thatmotor activation module (180) is configured to provide activation ofmotor (160) with electrical power from battery pack (120) in response tothe paddle actuating the switch of motor activation module (180). Thus,motor (160) will be activated when firing trigger (150) is pivoted. Thisactivation of motor (160) will actuate stapling head assembly (300) asdescribed in greater detail below.

Battery pack (120) is operable to provide electrical power to a motor(160) as noted above. Battery pack (120) may be removably coupled withhandle assembly (100) through a snap fit or in any other suitablefashion. It should be understood that battery pack (120) and handleassembly (100) may have complementary electrical contacts, pins andsockets, and/or other features that provide paths for electricalcommunication from battery pack (120) to electrically powered componentsin handle assembly (100) when battery pack (120) is coupled with handleassembly (100). It should also be understood that, in some versions,battery pack (120) is unitarily incorporated within handle assembly(100) such that battery back (120) cannot be removed from handleassembly (100).

C. Exemplary Anastomosis Procedure with Circular Stapling Instrument

FIGS. 7-10 show an exemplary surgical procedure for providing a surgicalanastomosis using instrument (10). In various instances, an anastomosismay be performed to remove a section of a patient's gastrointestinal(GI) tract. In the present example, multiple portions of a patient'scolon are severed and stapled to resect a diseased portion (C′) of thecolon (C). The remaining severed and stapled portions of colon (C) arethen anastomosed together, as discussed in further detail below.

As shown in FIG. 7, multiple endocutter staplers (1000) may be insertedinto a patient to sever and staple portions of the patient's colon (C).By way of example only, endocutter staplers (1000) may be constructedand operable in accordance with at least some of the teachings of U.S.Pat. No. 4,805,823, entitled “Pocket Configuration for Internal OrganStaplers,” issued Feb. 21, 1989; U.S. Pat. No. 5,415,334, entitled“Surgical Stapler and Staple Cartridge,” issued May 16, 1995; U.S. Pat.No. 5,465,895, entitled “Surgical Stapler Instrument,” issued Nov. 14,1995; U.S. Pat. No. 5,597,107, entitled “Surgical Stapler Instrument,”issued Jan. 28, 1997; U.S. Pat. No. 5,632,432, entitled “SurgicalInstrument,” issued May 27, 1997; U.S. Pat. No. 5,673,840, entitled“Surgical Instrument,” issued Oct. 7, 1997; U.S. Pat. No. 5,704,534,entitled “Articulation Assembly for Surgical Instruments,” issued Jan.6, 1998; U.S. Pat. No. 5,814,055, entitled “Surgical ClampingMechanism,” issued Sep. 29, 1998; U.S. Pat. No. 6,978,921, entitled“Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism,”issued Dec. 27, 2005; U.S. Pat. No. 7,000,818, entitled “SurgicalStapling Instrument Having Separate Distinct Closing and FiringSystems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923, entitled“Surgical Stapling Instrument Having a Firing Lockout for an UnclosedAnvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled “SurgicalStapling Instrument Incorporating a Multi-Stroke Firing Mechanism with aFlexible Rack,” issued Dec. 4, 2007; U.S. Pat. No. 7,367,485, entitled“Surgical Stapling Instrument Incorporating a Multistroke FiringMechanism Having a Rotary Transmission,” issued May 6, 2008; U.S. Pat.No. 7,380,695, entitled “Surgical Stapling Instrument Having a SingleLockout Mechanism for Prevention of Firing,” issued Jun. 3, 2008; U.S.Pat. No. 7,380,696, entitled “Articulating Surgical Stapling InstrumentIncorporating a Two-Piece E-Beam Firing Mechanism,” issued Jun. 3, 2008;U.S. Pat. No. 7,404,508, entitled “Surgical Stapling and CuttingDevice,” issued Jul. 29, 2008; U.S. Pat. No. 7,434,715, entitled“Surgical Stapling Instrument Having Multistroke Firing with OpeningLockout,” issued Oct. 14, 2008; U.S. Pat. No. 7,721,930, entitled“Disposable Cartridge with Adhesive for Use with a Stapling Device,”issued May 25, 2010; U.S. Pat. No. 8,408,439, entitled “SurgicalStapling Instrument with An Articulatable End Effector,” issued Apr. 2,2013; and U.S. Pat. No. 8,453,914, entitled “Motor-Driven SurgicalCutting Instrument with Electric Actuator Directional Control Assembly,”issued Jun. 4, 2013. The disclosure of each of the above-cited U.S.patents is incorporated by reference herein.

In the example shown, endocutter staplers (1000) are inserted into thebody laparoscopically via respective trocars. Endocutter stapler (1000)comprises a shaft (1120) and an end effector (1110) extending from theshaft (1120). End effector (1110) comprises a first jaw (1112) and asecond jaw (1114). First jaw (1112) comprises a staple cartridge (1140).Staple cartridge (1140) is insertable into and removable from first jaw(1112), though some variations may provide a staple cartridge that isnot removable from (or at least readily replaceable from) first jaw(1112). Second jaw (1114) comprises an anvil (1130) that is configuredto deform staples ejected from staple cartridge (1140). Second jaw(1114) is pivotable relative to first jaw (1112), though some variationspay provide first jaw (1112) as being pivotable relative to the secondjaw (1114). Endocutter staplers (1000) may be configured ad operable inaccordance with at least some of the teachings of U.S. Pub. No.2013/0168435, entitled “Surgical Stapling Instrument with anArticulatable End Effector,” published Jul. 4, 2013, now U.S. Pat. No.9,138,225, issued Sep. 22, 2015, the disclosure of which is incorporatedby reference. While end effector (1110) is straight and is thusconfigured to apply a straight line of staples (185) in the presentexample, in other examples end effector (1110) may be curved and maythus apply a curved line of staples (185).

Anvil (1130) of endocutter stapler (1000) can be opened such that anvil(1130) and staple cartridge (1140) of endocutter stapler (1000) arepositioned relative to the patient's colon (C). When anvil (1130) ismoved into a closed position, anvil (1130) clamps the colon (C) againststaple cartridge (1140). Turning now to FIG. 7, endocutter stapler(1000) can be operated to sever and staple the colon (C) at a first, orupper, location. In the example shown, three linear rows of staples(185) are implanted on the upper side of the severed upper portion (UC)of colon (C) and three rows of the staples (185) are implanted in theadjacent region of the diseased portion (C′) of the colon (C). The sameendocutter stapler (1000) (if reloaded with another cartridge (1140)),or another endocutter stapler (1000), can be operated to sever andstaple the colon (C) at a second, or lower, location. In the presentexample, three linear rows of staples (285) implanted on the lower sideof the severed lower portion (LC) of the colon (C) and three rows ofstaples (285) are implanted in the adjacent region of the diseasedportion (C′) of the colon (C). However, in other examples, othersuitable configurations of staples may be implanted onto the upperportion (UC) and/or the lower portion (LC) of the colon (C). Once thecolon (C) has been transected and stapled at the upper location and thelower location, the diseased portion (C′) of the colon can be removedfrom the patient, as illustrated in FIGS. 8-10.

Referring again to FIGS. 8-9, circular stapler (10) may be utilized toanastomose the upper portion (UC) and the lower portion (LC) of thecolon (C). An operator inserts a portion of shaft (210) and staplinghead assembly (300) into the rectum (R) of the patient into the lowerportion (LC) of the colon (C). In the example shown, a user then insertstrocar (330) through the rows of staples (285). Trocar (330) of circularstapler (10) may then be positioned in the upper portion of the colon C.In various instances, the sidewall of the upper portion of the colon Ccan be incised and trocar (330) can then be positioned inside the upperportion. Anvil (400) may then be directed into the upper portion of thecolon (C) and connected to trocar (330) in the manner discussed aboveand as shown in FIG. 8.

The operator may then draw anvil (400) toward stapling head assembly(300), in the manner described above (e.g., utilizing knob (130), thusalso drawing the upper colon portion (UC) toward the lower colon portion(LC). The operator may then retract trocar (330) until the tissue of theupper colon portion (UC) and the lower colon portion (LC) are compressedagainst deck (320) as shown in FIG. 9. It should also be understood thatknob (130) may be rotated in a first angular direction (e.g., clockwise)to retract anvil (400) toward stapling head assembly (300); and in asecond angular direction (e.g., counterclockwise) to advance anvil (400)away from stapling head assembly (300). Knob (130) may thus be used toadjust the gap distance between opposing surfaces of anvil (400) andstapling head assembly (300) until a suitable gap distance has beenachieved, such as in the manner discussed in U.S. Pub. No. 2016/0374670,published Dec.29, 2016, the disclosure of which is incorporated byreference herein. As shown in FIG. 9, flap regions (FR) are formed inthe lower portion (LC) of the colon (C) as anvil (400) is drawn towardstapling head assembly (300). These flap regions (FR) extend outwardlyfrom the region of tissue compressed between anvil (400) and staplinghead assembly (300).

As discussed above, stapling head assembly (300) is configured to applyannular arrays of staples (385) in the tissue captured between anvil(400) and stapling head assembly (300). Knife member (340) is advancedtoward anvil (440) to sever the tissue positioned radially inwardly withrespect to the annular arrays of staples (385) applied by circularstapling instrument (10). After the staples (385) have been fired andtissue has been severed, anvil (400) and stapling head assembly (300)may together be withdrawn from the patient's rectum (R). The incisionthat was used to insert anvil (400) into the upper portion (UC) of thecolon (C) may be closed via suturing or using any other suitabletechnique.

As shown in FIG. 10, the upper portion (UC) of the colon (C) and thelower portion (LC) of the colon (C) are held together by the annulararray of staples (385) deployed by circular stapling instrument (10).The deployed annular array of staples (385) forms an anastomosis (A)that allows fluid tight communication from the upper portion (UC) of thecolon (C) to the lower portion (LC) of the colon (C). Some of staples(285) that were deployed by endocutter stapler (1000) will be removedwith the tissue that was transected by knife member (340) duringactuation of stapling head assembly (300). However, in this example,there are some staples (285) remaining in the outwardly projecting flapregions (FR) in the lower portion (LC) of the colon (C), outside of theanastomosis (A). This is due to the fact that the flap regions (FR)define a width (a) that is substantially greater than the diameter (b)of knife member (340), as best seen in FIG. 9. The flap regions (FR) maynevertheless remain sealed by those remaining staples (285).

II. Exemplary Alternative Staple Cartridges

In some instances, staples (385) that were deployed by circular staplinginstrument (10) may overlap with at least some of staples (285) thatwere deployed by endocutter stapler (1000) in the procedure describedabove with reference to FIGS. 7-10. Such overlap may prevent properformation of staples (385), which may compromise the integrity ofanastomosis (A) in the long term. In addition or in the alternative, atleast some of staples (285) that were deployed by endocutter stapler(1000) may interfere with compression of tissue between anvil (400) anddeck member (320) and/or the traversal of knife member (340) through thetissue, which may also compromise the integrity of anastomosis (A) inthe long term. Furthermore, there may be instances where the sealprovided by staples (285) in flap regions (FR) of the lower portion (LC)of the colon (C) may eventually fail over time. It may therefore bedesirable to provide features that prevent the outward extension of flapregions (FR) and position all of staples (285) and flap regions (FR)within the diameter (b) of knife member (340). Various examples of suchfeatures will be described in greater detail below.

A. Exemplary Alternative Staple Cartridge Including Buttress withMagnetic Elements

FIG. 11 shows an exemplary alternative staple cartridge (510) that maybe inserted into first jaw (1112) of end effector (1110) and used duringthe act of separating the diseased portion (C′) of the colon (C) fromthe lower portion (LC) of the colon (C) as described above withreference to FIG. 7. Staple cartridge (510) is substantially similar tostaple cartridge (1140), except for that staple cartridge (510) includestwo rows of staple cavities (545) on each side of slot (560) of insteadof three rows. Therefore, when staple cartridge (510) is incorporatedinto endocutter stapler (1000), two rows of staples (585) are implantedonto opposing, severed portions of tissue rather than three rows ofstaples (585).

Staple cartridge (510) of the present example further includes abuttress (550) that is secured to deck (570). Buttress (550) comprises abuttress body (560) with outer magnets (552 a) and inner magnets (552b). Various suitable forms that buttress body (560) may take will beapparent to those of ordinary skill in the art in view of the teachingsherein. By way of example only, buttress body (560) may be formed by amesh of woven material that is provided in the form of a thin sheet. Inthe example shown, buttress (550) is removably adhered to deck (570),but in other examples buttress (550) may be associated with or coupledto cartridge (540) in a different manner (e.g., via clips, via hook andloop fasteners, etc.). When an end effector (1110) that incorporatesstaple cartridge (510) is actuated, buttress (550) will be severed alongslot (560) and stapled onto tissue along with staples (585), as shownbest in FIG. 12.

As shown, magnets (552 a, 552 b) are coupled to and positioned to restatop buttress body (580) (e.g., facing anvil (1130)). In other examples,however, magnets (552 a, 552 b) may be otherwise coupled to buttressbody (580), such as below buttress body (580) (e.g., facing cartridgedeck (570)), or may be embedded within buttress body (580). Magnets (552a, 552 b) are adhered to buttress body (580) in the present example, butin other examples magnets (552 a, 552 b) may be coupled to buttress(550) in some other fashion (e.g., positioned between two apposed layersof material that form buttress body (580)). In the present example,magnets (552 a, 552 b) are shown to be permanent pill magnets with acircular shape. Of course, magnets (552 a, 552 b) may instead have anyother suitable shape.

Each magnet (552 a) is configured to be attracted to an adjacent magnet(552 b), as shown in FIG. 12 and as will be discussed in further detailbelow. In particular, magnets (552 a) are each oriented such that theirnorth pole is facing deck (570) while magnets (552 b) are each orientedsuch that their south pole is facing deck (570). Alternatively, theseorientations may be reversed. In some examples, end effector (1110) isconfigured such that magnets (552 a, 552 b) will not come into proximityto ferrous material. For instance, anvil (1130) may be formed of anon-ferrous material such that magnets (552 a, 552 b) will not beattracted to anvil (1130).

FIGS. 14A-14C show steps an anastomosis procedure similar to theprocedure shown in FIGS. 7-10. In FIG. 14A, the upper colon portion (UC)and the lower colon portion (LC) are shown to have been severed andstapled in a similar manner to that shown in FIGS. 7-8. However, in thisexample the lower colon portion (LC) has been severed and stapledutilizing staple cartridge (510). The lower colon portion (LC) thereforeincludes staples (585) and buttress (550) coupled thereto in the mannerdiscussed above. As shown, a portion of shaft (210) and stapling headassembly (300) are inserted into the rectum (R) of the patient and intothe lower portion (LC) of the colon (C). In the example shown, trocar(330) is inserted through the line of staples (585) such that trocar(330) is exposed out of lower colon portion (LC). Anvil (400) is shownto be positioned in the upper portion (UC) of the colon (C), with shank(420) extending through an opening of the upper colon portion (UC).

As shown in FIG. 14A (and as also shown in FIG. 13), each end of thesevered and stapled lower portion (LC) has been folded inwardly suchthat each outer magnet (552 a) magnetically couples with the respectiveinner magnet (552 b). Therefore, at least part of the lower colonportion (LC) is shown to be drawn radially inwardly toward trocar (330),such that the line of staples (585) lies within the cutting line ofknife (340). In other words, the coupling of magnets (552 a, 552 b) witheach other will effectively fold flap regions (FR) inwardly. Thecircular cutting line of knife member (340) is defined by the diameter(b) of knife member (340). As shown in FIGS. 13 and 14B, when magnets(552 a, 552 b) are coupled together, the severed tissue at the end oflower colon portion (LC) defines a width (c) that is smaller than thediameter (b) of knife member (340). Thus, all of the applied staples(585) and all of the tissue at the severed end of lower colon portion(LC) are positioned within a cylindrical plane defined by knife member(340). It should be understood that the operator may use conventionaltissue graspers, a portion of end effector (1100), and/or any othersuitable structures or techniques to initiate the inward folding of flapregions (FR) to couple corresponding magnets (552 a, 552 b) together.

With magnets (552 a, 552 b) coupled together to secure flap regions (FR)in an inwardly folded configuration, the operator then connects shank(420) to trocar (330) in the manner discussed above. Alternatively, theoperator may fold of flap regions (FR) inwardly to couple correspondingmagnets (552 a, 552 b) together after shank (420) and trocar (330) arecoupled to one another. Referring to FIG. 14B, the operator may thendraw anvil (400) toward stapling head assembly (300), in the mannerdescribed above (e.g., utilizing knob (130)), thus also drawing theupper colon portion (UC) toward the lower colon portion (LC). Theoperator may then retract trocar (330) until the tissue of the uppercolon portion (UC) and the lower colon portion (LC) are compressedagainst the deck member (320) to achieve a desirable gap distance, asshown in FIG. 14B and discussed above.

The operator may then actuate trigger (150) to actuate stapling headassembly (300), resulting in the stapling and severing of tissue in asimilar manner as shown in FIG. 9 to form an anastomosis (A). However,due to the position of the applied staples (585) and all of the tissueat the severed end of lower colon portion (LC) being radially inward ofthe cut line of circular knife (340) as discussed above, all of thetissue in which staples (585) are applied is severed and no staples(585) are disposed in the tissue that remains at the resultinganastomosis (A) site as shown in FIG. 14C. Moreover, staples (585) donot impede the successful operation of circular stapler (10), and thereare no flap regions (FR) extending outwardly from the anastomosis (A)site. The severed portion of tissue including staples (585) may beremoved by the user via the patient's rectum.

B. Exemplary Alternative Staple Cartridge Including Magnetic Staples

FIGS. 15-16 show lower colon portion (LC) after endocutter stapler(1000) has been utilized to staple and sever a portion of lower colonportion (LC). As shown, rather than including a plurality of staples(585), staple line includes three rows of staples including two sectionsof outer staples (685 a) and a section of inner staples (685 b) betweenthe outer staples (685 b). In the present example, outer staples (685 a)are ferromagnetic and inner staples (685 b) are non-ferromagnetic. Inother examples, the staple line may include a different number of staplerows, such as one or two, or more than three. As shown, three in thefirst row, two in the second row, and three in the third row of outerstaples (685 a) (on each side) are ferromagnetic, while three in thefirst row, four in the second row, and three in the third row of innerstaples (685 b) are non-ferromagnetic. In some examples, some or all ofouter staples (685 a) may be comprised entirely of a ferromagneticmaterial.

In some examples, some or all of outer staples (685 a) may be onlypartially comprised of a ferromagnetic material and partially of anon-ferromagnetic material. In such examples, some or all of outerstaples (685 a) may include a ferromagnetic core or portion that iscoated with a non-ferromagnetic material. Additionally or alternatively,some or all of outer staples may include a non-ferromagnetic core orportion that is coated with a ferromagnetic material. Suitable otherconfigurations of outer staples (685 a) will be understood by personsskilled in the art in view of the teachings herein. Various suitableferromagnetic materials (iron and alloys thereof, nickel and alloysthereof, etc.) and non-ferromagnetic materials (e.g., titanium,stainless steel, cobalt chromium, etc.) will be apparent to personsskilled in the art in view of the teachings herein.

FIG. 16 shows a step of an anastomosis procedure similar to the stepsshown in FIGS. 8 and 14A. Particularly, upper colon portion (UC) andlower colon portion (LC) are shown to have been severed and stapled in asimilar manner to that shown in FIGS. 7-8 and 14A-B. However, at leastthe lower colon portion (LC) has been severed and stapled utilizing astaple cartridge (e.g., staple cartridge (1140)) including staples (685a, 685 b) configured to be implanted in tissue as shown in FIG. 15.Lower colon portion therefore includes staples (685 a, 685 b) coupledthereto in the manner discussed above. As shown, a portion of shaft(210) and stapling head assembly (300) are inserted into the rectum (R)of the patient and into the lower portion of the colon (C).

The circular stapler of the present example includes a modified trocar(1330) that is substantially identical to trocar (330), except thattrocar (1330) includes a permanent magnet (1331) embedded therein. Insome other examples, magnet (1331) may be on a different portion ofcircular stapler (10), such as in a different part of stapling headassembly (300). Other suitable configurations and positions of magnet(1331) will be apparent to persons skilled in the art in view of theteaching herein. In the present example, magnet (1331) is a rare earthmagnetic material such as samarium-cobalt, neodymium, etc. Othersuitable materials that magnet (1331) may comprise will be apparent topersons skilled in the art in view of the teachings herein. As anothermerely illustrative alternative, magnet (1331) may comprise anelectromagnet. This may enable the operator to selectively activatemagnet (1331) to generate a magnetic field at the appropriate timeduring the surgical procedure (e.g., by manipulating an activation inputfeature on handle assembly (100), etc.). Similarly, some versions ofmagnets (552) of buttress (550) described above may compriseelectromagnets that are capable of selective activation in any suitableway as will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

In the example shown, trocar (1330) is inserted through the line ofinner staples (685 b) such that trocar (1330) is exposed out of lowercolon portion (LC). Anvil (400) is shown to be positioned in the upperportion (UC) of the colon (C), with shank (420) extending through anopening of the upper colon portion (UC). As shown, outer staples (685 a)are attracted to magnet (1331), drawing outer flap regions (FR) of lowercolon portion (LC) radially inwardly toward trocar (1330), such that thesevered tissue at the end of lower colon portion (LC) defines a width(d) that is smaller than the diameter (b) of knife member (340). Themagnetic attraction between staples (685 a) and magnet (1331) may be ata level such that upon trocar (1330) being inserted through line ofinner staples (685 b), staples (685 a) are automatically magneticallydrawn toward magnet (1331). In some instances, however, the operator maygrasp the tissue at flap regions (FR) or otherwise manipulate the tissueat flap regions (FR) and thereby urge staples (685 a) toward magnet(1331) until staples (685 a) and magnet (1331) are magnetically coupled.

Once staples (685 a) are coupled with magnet (1331) and thereby hold allof the applied staples (685 a, 685 b) and all of the tissue at thesevered end of lower colon portion (LC) in position within a cylindricalplane defined by knife member (340), the operator connects shank (420)to trocar (1330) in the manner discussed above. Alternatively, theoperator may connect shank (420) to trocar (1330) after staples (685 a)are magnetically coupled to magnet (1331). The operator may then drawanvil (400) toward stapling head assembly (300), in the manner describedabove (e.g., utilizing knob (130)), thus also drawing the upper colonportion (UC) toward the lower colon portion (LC). The operator may thenretract trocar (1330) until the tissue of the upper colon portion (UC)and the lower colon portion (LC) are compressed against the deck member(320) to achieve a desirable gap distance, in a similar manner as shownin FIG. 15B.

The operator may then actuate trigger (150) to actuate stapling headassembly (300), resulting in the stapling and severing of tissue in asimilar manner as shown in FIG. 9. As with the example shown in FIGS.15A-15C, due to the position of the applied staples (585) and all of thetissue at the severed end of lower colon portion (LC) being radiallyinward of the cut line of circular knife (340) as discussed above, allof the tissue in which staples (685 a, 685 b) are applied is severed andno staples (685 a, 685 b) are disposed in the tissue that remains at theresulting anastomosis site. Moreover, staples (685 a, 685 b) do notimpede the successful operation of circular stapler (10), and there areno flap regions (FR) extending outwardly from the anastomosis site. Thesevered portion of tissue including staples (685 a, 685 b) may beremoved by the user via the patient's rectum.

III. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

An apparatus comprising a staple cartridge, wherein the staple cartridgecomprises: (i) a plurality of staples, (ii) a deck, wherein the deckdefines a plurality of openings, wherein each opening of the pluralityof openings is associated with a corresponding staple of the pluralityof staples, such that each staple is configured to pass through acorresponding opening of the plurality of openings, and (iii) a magneticfeature, wherein the magnetic feature is configured to be coupled totissue in response to actuation of the staple cartridge, wherein themagnetic feature is configured to retain at least one outer portion ofstapled tissue in an inwardly folded position relative to an innerportion of stapled tissue.

Example 2

The apparatus of Example 1, wherein the staple cartridge furthercomprises a buttress, wherein the magnetic feature is positioned on thebuttress.

Example 3

The apparatus of Example 2, wherein the magnetic feature comprises aplurality of magnets embedded in the buttress.

Example 4

The apparatus of any one or more of Examples 2 through 3, wherein themagnetic feature comprises a plurality of magnets positioned on thebuttress.

Example 5

The apparatus of Example 4, wherein the magnets are positioned on one orboth of a top portion or a bottom portion of the buttress.

Example 6

The apparatus of Example 5, wherein the magnets are adhered to thebuttress.

Example 7

The apparatus of any one or more of Examples 2 through 6, wherein thebuttress is adhered to the deck.

Example 8

The apparatus of any one or more of Examples 2 through 7, wherein themagnetic feature comprises an inner magnet and an outer magnet securedto the buttress, wherein the outer magnet is configured to magneticallycouple to the inner magnet in response to the at least one outer portionof stapled tissue being folded inwardly toward the inner portion ofstapled tissue.

Example 9

The apparatus of Example 8, wherein the buttress comprises a first pairof inner and outer magnets at one end of the buttress and a second pairof inner and outer magnets at another end of the buttress.

Example 10

The apparatus of any one or more of Examples 1 through 9, wherein atleast some of the staples comprise a ferromagnetic material to form themagnetic feature.

Example 11

The apparatus of any one or more of Examples 1 through 10, wherein thestaples comprise an inner portion of staples between two opposing outerportions of staples, wherein the outer staples comprise a ferromagneticmaterial to form the magnetic feature.

Example 12

The apparatus of Example 11, wherein the inner staples consistessentially of a non-ferromagnetic material.

Example 13

The apparatus of any one or more of Examples 1 through 12, furthercomprising a circular stapler, wherein the circular stapler comprises:(i) an anvil, and (ii) a stapling head assembly, wherein the staplinghead assembly comprises: (A) a rod configured to engage the anvil, (B) aknife member configured to form a circular cut line in tissue, and (C) astaple driver, wherein the anvil and stapling head assembly areconfigured to cooperate to clamp and staple tissue; wherein the magneticfeature is configured to magnetically couple to a portion of thecircular stapler.

Example 14

The apparatus of Example 13, wherein the magnetic feature is configuredto magnetically couple to the rod of the circular stapler.

Example 15

The apparatus of any one or more of Examples 13 through 14, wherein themagnetic feature is configured to retain at least one outer portion ofstapled tissue in an inwardly folded position relative to an innerportion of stapled tissue within a circular cut line formed by the knifemember.

Example 16

The apparatus of any one or more of Examples 1 through 15, furthercomprising: (a) an end effector, wherein the end effector comprises: (i)an anvil, and (ii) a lower jaw, wherein the anvil is pivotable towardthe lower jaw to capture tissue between the anvil and the lower jaw,wherein the staple cartridge is secured to the lower jaw; and (b) astapling and severing mechanism in communication with the shaft assemblyand end effector, wherein the stapling and severing mechanism isconfigured to sever and staple tissue clamped between the anvil and thelower jaw.

Example 17

A method of operating on tissue using a circular stapler, wherein thecircular stapler comprises an anvil, and a stapling head assembly,wherein the stapling head assembly includes a rod, a knife member, and astaple driver, wherein the knife member is configured to provide acircular cut line, wherein the anvil and the stapling head assembly areconfigured to cooperate to clamp and staple tissue, wherein the methodcomprises: (a) severing and stapling a first portion of anatomicalstructure using a non-circular stapler, thereby leaving a plurality ofstaples and a first magnetic feature on a severed end portion of thefirst portion of anatomical structure; (b) inserting the anvil of thecircular stapler into a second portion of anatomical structure; (c)inserting the stapling head assembly into the first portion ofanatomical structure until at least a portion of the rod extends pastthe severed end portion of the first portion of anatomical structure;(d) drawing the first magnetic feature inwardly toward the rod such thatthe first magnetic feature magnetically couples with a second magneticfeature, thereby holding the plurality of staples on the severed endportion at a position inward of the cut line of the knife member; (e)coupling the rod and the anvil; (f) clamping the first and secondportions of anatomical structure together between the anvil and thesapling head assembly; (g) directing the drivable knife member towardthe anvil, thereby severing the severed end portion and the staples fromthe first portion of anatomical structure and at least part of thesecond portion of anatomical structure; and (h) stapling the first andsecond portions of anatomical structure together using the staple driver

Example 18

The method of Example 17, wherein the first and second magnetic featuresare disposed on a buttress associated with the non-circular stapler.

Example 19

The method of any of Examples 17 through 18, wherein the second magneticfeature is positioned on the circular stapler.

Example 20

A method of operating on tissue using a circular stapler, wherein thecircular stapler comprises an anvil, and a stapling head assembly,wherein the stapling head assembly includes a rod, a knife member, and astaple driver, wherein the knife member is configured to provide acircular cut line, wherein the anvil and the stapling head assembly areconfigured to cooperate to clamp and staple tissue, wherein the methodcomprises: (a) severing and stapling a first portion of the colon usinga non-circular stapler, thereby leaving a first plurality of staples anda first magnetic feature on a first severed end portion of the firstportion of the colon; (b) severing and stapling a second portion of thecolon using a non-circular stapler, thereby leaving a second pluralityof staples on a second severed end portion of the second portion of thecolon; (c) inserting the anvil of the circular stapler into the secondportion of the colon; (d) inserting the stapling head assembly into thefirst portion of the colon until at least a portion of the rod extendspast the severed end portion of the first portion of the colon; (e)drawing the first severed end portion inward toward the rod such thatthe first plurality of staples and the first severed end portion lieradially inwardly of the cut line of the knife member and the firstmagnetic feature couples to a second magnetic feature; (f) directing thedrivable knife member toward the anvil, thereby severing the firstsevered end portion and the first plurality of staples from the firstportion of the patient's colon and at least part of the second portionof the patient's colon; and (g) stapling the first and second portionsof the colon together.

IV. Miscellaneous

It should also be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

At least some of the teachings herein may be readily combined with oneor more teachings of U.S. Pat. No. 7,794,475, entitled “Surgical StaplesHaving Compressible or Crushable Members for Securing Tissue Therein andStapling Instruments for Deploying the Same,” issued Sep. 14, 2010, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2014/0151429, entitled “Trans-Oral Circular Anvil Introduction Systemwith Dilation Feature,” published Jun. 5, 2014, now U.S. Pat. No.9,572,573, issued Feb. 21, 2017, the disclosure of which is incorporatedby reference herein; U.S. Pub. No. 2014/0144968, entitled “SurgicalStaple with Integral Pledget for Tip Deflection,” published May 29,2014, now U.S. Pat. No. 9,289,207, issued Mar. 22, 2016, the disclosureof which is incorporated by reference herein; U.S. Pub. No.2014/0158747, entitled “Surgical Stapler with Varying Staple Widthsalong Different Circumferences,” published Jun. 12, 2014, now abandonedthe disclosure of which is incorporated by reference herein; U.S. Pub.No. 2014/0144969, entitled “Pivoting Anvil for Surgical CircularStapler,” published May 29, 2014, now U.S. Pat. No. 9,498,222, issuedNov. 22, 2016, the disclosure of which is incorporated by referenceherein; U.S. Pub. No. 2014/0151430, entitled “Circular AnvilIntroduction System with Alignment Feature,” published Jun. 5, 2014, nowU.S. Pat. No. 9,724,100, issued Aug. 8, 2017, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2014/0166717, entitled“Circular Stapler with Selectable Motorized and Manual Control,Including a Control Ring,” published Jun. 19, 2014, now U.S. Pat.No.9,532,783, issued Jan. 3, 2017, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2014/0166728, entitled“Motor Driven Rotary Input Circular Stapler with Modular End Effector,”published Jun. 19, 2014, now U.S. Pat. No. 9,597,081, issued Mar. 21,2017, the disclosure of which is incorporated by reference herein;and/or U.S. Pub. No. 2014/0166718, entitled “Motor Driven Rotary InputCircular Stapler with Lockable Flexible Shaft,” published Jun. 19, 2014,now U.S. Pat. No. 9,463,022, issued Oct. 11, 2016, the disclosure ofwhich is incorporated by reference herein. Various suitable ways inwhich such teachings may be combined will be apparent to those ofordinary skill in the art.

While the examples herein have been provided in the context of acircular stapling instrument, it should be understood that the variousteachings herein may be readily applied to various other kinds ofsurgical instruments. By way of example only, the various teachingsherein may be readily applied to linear stapling devices (e.g.,endocutters). For instance, various teachings herein may be readilycombined with various teachings of U.S. Pub. No. 2012/0239012, entitled“Motor-Driven Surgical Cutting Instrument with Electric ActuatorDirectional Control Assembly,” published Sep. 20, 2012, now U.S. Pat.No. 8,453,914, issued Jun. 4, 2013, the disclosure of which isincorporated by reference herein, and/or U.S. Pub. No. 2010/0264193,entitled “Surgical Stapling Instrument with An Articulatable EndEffector,” published Oct. 21, 2010, now U.S. Pat. No. 8,408,439, issuedApr. 2, 2013, the disclosure of which is incorporated by referenceherein, as will be apparent to those of ordinary skill in the art. Asanother merely illustrative example, the various teachings herein may bereadily applied to a motorized electrosurgical device. For instance,various teachings herein may be readily combined with various teachingsof U.S. Pub. No. 2012/0116379, entitled “Motor Driven ElectrosurgicalDevice with Mechanical and Electrical Feedback,” published May 10, 2012,now U.S. Pat. No. 9,161,803, issued Oct. 20, 2015, the disclosure ofwhich is incorporated by reference herein, as will be apparent to thoseof ordinary skill in the art. Other suitable kinds of instruments inwhich the teachings herein may be applied, and various ways in which theteachings herein may be applied to such instruments, will be apparent tothose of ordinary skill in the art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. An apparatus comprising a staple cartridge, wherein thestaple cartridge comprises: (i) a plurality of staples, (ii) a deck,wherein the deck defines a plurality of openings, wherein each openingof the plurality of openings is associated with a corresponding stapleof the plurality of staples, such that each staple is configured to passthrough a corresponding opening of the plurality of openings, and (iii)a magnetic feature, wherein the magnetic feature is configured to becoupled to tissue in response to actuation of the staple cartridge,wherein the magnetic feature is configured to retain at least one outerportion of stapled tissue in an inwardly folded position relative to aninner portion of stapled tissue; wherein the magnetic feature comprisesone or more magnets.
 2. The apparatus of claim 1, wherein the staplecartridge further comprises a buttress, wherein the magnetic feature ispositioned on the buttress.
 3. The apparatus of claim 2, wherein themagnetic feature comprises a plurality of magnets embedded in thebuttress.
 4. The apparatus of claim 2, wherein the magnetic featurecomprises a plurality of magnets positioned on the buttress.
 5. Theapparatus of claim 4, wherein the magnets are positioned on one or bothof a top portion or a bottom portion of the buttress.
 6. The apparatusof claim 5, wherein the magnets are adhered to the buttress.
 7. Theapparatus of claim 2, wherein the buttress is adhered to the deck. 8.The apparatus of claim 2, wherein the magnetic feature comprises aninner magnet and an outer magnet secured to the buttress, wherein theouter magnet is configured to magnetically couple to the inner magnet inresponse to the at least one outer portion of stapled tissue beingfolded inwardly toward the inner portion of stapled tissue.
 9. Theapparatus of claim 8, wherein the magnetic feature comprises a firstpair of inner and outer magnets at one end of the buttress and a secondpair of inner and outer magnets at another end of the buttress.
 10. Theapparatus of claim 1, wherein at least some of the staples comprise aferromagnetic material to form the magnetic feature.
 11. The apparatusof claim 1, wherein the staples comprise an inner portion of staplesbetween two opposing outer portions of staples, wherein the outerstaples comprise a ferromagnetic material to form the magnetic feature.12. The apparatus of claim 11, wherein the inner staples consistessentially of a non-ferromagnetic material.
 13. The apparatus of claim1, further comprising a circular stapler, wherein the circular staplercomprises: (i) an anvil, and (ii) a stapling head assembly, wherein thestapling head assembly comprises: (A) a rod configured to engage theanvil, (B) a knife member configured to form a circular cut line intissue, and (C) a staple driver, wherein the anvil and stapling headassembly are configured to cooperate to clamp and staple tissue; whereinthe magnetic feature is configured to magnetically couple to a portionof the circular stapler.
 14. The apparatus of claim 13, wherein themagnetic feature is configured to magnetically couple to the rod of thecircular stapler.
 15. The apparatus of claim 13, wherein the magneticfeature is configured to retain at least one outer portion of stapledtissue in an inwardly folded position relative to an inner portion ofstapled tissue within a circular cut line formed by the knife member.16. The apparatus of claim 1, further comprising: (a) an end effector,wherein the end effector comprises: (i) an anvil, and (ii) a lower jaw,wherein the anvil is pivotable toward the lower jaw to capture tissuebetween the anvil and the lower jaw, wherein the staple cartridge issecured to the lower jaw; and (b) a stapling and severing mechanism incommunication with the shaft assembly and end effector, wherein thestapling and severing mechanism is configured to sever and staple tissueclamped between the anvil and the lower jaw.
 17. A method of operatingon tissue using a circular stapler, wherein the circular staplercomprises an anvil, and a stapling head assembly, wherein the staplinghead assembly includes a rod, a knife member, and a staple driver,wherein the knife member is configured to provide a circular cut line,wherein the anvil and the stapling head assembly are configured tocooperate to clamp and staple tissue, wherein the method comprises: (a)severing and stapling a first portion of anatomical structure using anon-circular stapler, thereby leaving a plurality of staples and a firstmagnetic feature on a severed end portion of the first portion ofanatomical structure; (b) inserting the anvil of the circular staplerinto a second portion of anatomical structure; (c) inserting thestapling head assembly into the first portion of anatomical structureuntil at least a portion of the rod extends past the severed end portionof the first portion of anatomical structure; (d) drawing the firstmagnetic feature inwardly toward the rod such that the first magneticfeature magnetically couples with a second magnetic feature, therebyholding the plurality of staples on the severed end portion at aposition inward of the cut line of the knife member; (e) coupling therod and the anvil; (f) clamping the first and second portions ofanatomical structure together between the anvil and the sapling headassembly; (g) directing the drivable knife member toward the anvil,thereby severing the severed end portion and the staples from the firstportion of anatomical structure and at least part of the second portionof anatomical structure; and (h) stapling the first and second portionsof anatomical structure together using the staple driver.
 18. The methodof claim 17, wherein the first and second magnetic features are disposedon a buttress associated with the non-circular stapler.
 19. The methodof claim 17, wherein the second magnetic feature is positioned on thecircular stapler.
 20. A method of operating on tissue using a circularstapler, wherein the circular stapler comprises an anvil, and a staplinghead assembly, wherein the stapling head assembly includes a rod, aknife member, and a staple driver, wherein the knife member isconfigured to provide a circular cut line, wherein the anvil and thestapling head assembly are configured to cooperate to clamp and stapletissue, wherein the method comprises: (a) severing and stapling a firstportion of the colon using a non-circular stapler, thereby leaving afirst plurality of staples and a first magnetic feature on a firstsevered end portion of the first portion of the colon; (b) severing andstapling a second portion of the colon using a non-circular stapler,thereby leaving a second plurality of staples on a second severed endportion of the second portion of the colon; (c) inserting the anvil ofthe circular stapler into the second portion of the colon; (d) insertingthe stapling head assembly into the first portion of the colon until atleast a portion of the rod extends past the severed end portion of thefirst portion of the colon; (e) drawing the first severed end portioninward toward the rod such that the first plurality of staples and thefirst severed end portion lie radially inwardly of the cut line of theknife member and the first magnetic feature couples to a second magneticfeature; (f) directing the drivable knife member toward the anvil,thereby severing the first severed end portion and the first pluralityof staples from the first portion of the patient's colon and at leastpart of the second portion of the patient's colon; and (g) stapling thefirst and second portions of the colon together.